WO1998024378A1 - Appareil permettant d'acceder a l'espace pericardique et technique correspondante - Google Patents

Appareil permettant d'acceder a l'espace pericardique et technique correspondante Download PDF

Info

Publication number
WO1998024378A1
WO1998024378A1 PCT/US1997/022129 US9722129W WO9824378A1 WO 1998024378 A1 WO1998024378 A1 WO 1998024378A1 US 9722129 W US9722129 W US 9722129W WO 9824378 A1 WO9824378 A1 WO 9824378A1
Authority
WO
WIPO (PCT)
Prior art keywords
jaws
needle
pericardium
handle
bore
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1997/022129
Other languages
English (en)
Inventor
James R. Grabek
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Comedicus Inc
Original Assignee
Comedicus Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Comedicus Inc filed Critical Comedicus Inc
Priority to EP97950804A priority Critical patent/EP0952788A1/fr
Priority to AU53704/98A priority patent/AU744703B2/en
Priority to CA002273948A priority patent/CA2273948A1/fr
Priority to JP52576798A priority patent/JP2001505464A/ja
Publication of WO1998024378A1 publication Critical patent/WO1998024378A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3478—Endoscopic needles, e.g. for infusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A61B2018/00392—Transmyocardial revascularisation

Definitions

  • the present invention is directed to treating the heart muscle and associated coronary vessels by providing access to the pericardial space between the heart and the pericardium (pericardial sac), without injuring the heart and associated coronary vessels.
  • the present invention is directed to a device and method for safely accessing the pericardial space and directly infusing fluids including drugs therein or removing fluid(s) directly therefrom.
  • pericardium (pericardial sac) dates back to the time of Galen (129-200 A.D.) the Greek physician and anatomist who created the term "pericardium.”
  • the pericardium (pericardial sac) is a conical membranous sac in which the heart and the commencement of the great vessels are contained. Gray's Anatomy (1977 ed.) pp. 457-460.
  • the pericardium is fluid-filled and functions to prevent dilation of the chambers of the heart, lubricates the surfaces of the heart, and maintains the heart in a fixed geometric position. It also provides a barrier to the spread of infection from adjacent structures in the chest cavity and prevents surrounding tissue(s) from adhering to the heart.
  • the space between the pericardium and the heart is normally small in volume and includes the fluid therein. It has been reported by others that when fluid is injected into the pericardial space it accumulates in the atrioventricular and interventricular grooves, but not over the ventricular surfaces. See, Shabetai R, "Pericardial and Cardiac Pressure", in Circulation, 77:1 (1988).
  • Pericardiocentesis or puncture of the pericardium, heretofore has been performed for; 1) diagnosis of pericardial disease(s) by study of the pericardial fluid; 2) withdrawal of pericardial fluid for the treatment of acute cardiac tamponade; and 3) infusion of therapeutic agents for the treatment of malignant effusion or tumors.
  • pericardiocentesis procedures were performed in the United States and that less than 200 of these patients underwent therapy with the intrapericardial injection of drugs.
  • intrapericardial injection of drugs is clinically limited to the treatment of abnormal pericardial conditions and diseases, such as malignant or loculated pericardial effusions and tumors.
  • Drugs that have been injected into the pericardial space include antibiotic (sclerosing) agents, such as tetracycline, bleomycin and streptokinase.
  • antibiotic sclerosing
  • Intrapericardial drug delivery has not been clinically utilized for heart-specific treatments where pericardial pathology is normal, because the pericardial space is normally small and very difficult to access without invasive surgery or risk of cardiac injury by standard needle pericardiocentesis techniques.
  • pericardiocentesis procedures are carried out by highly specialized, experienced personnel in the cardiac catheterization laboratory of medical facilities, assisted by fluoroscopy and electrocardiogram monitoring equipment.
  • Electrocardiographic monitoring of pericardiocentesis, using the pericardial needle as an electrode is commonly employed, as disclosed in Bishop L.H., et al., "The Electrocardiogram as a Safeguard in Pericardiocentesis", in JAMA, 162:264 (1956), and Neill J. R., et al., "A Pericardiocentesis Electrode", in The New England Journal of Medicine, 264:711 (1961); Gotsman M.S., et al. "A Pericardiocentesis Electrode Needle", in Br.
  • needle pericardiocentesis there are complications associated with needle pericardiocentesis. These complications include laceration of a coronary artery or the right ventricle, perforation of the right atrium or ventricle, puncture of the stomach or colon, pneumothorax, arrhythmia, tamponade, hypertension, ventricular fibrillation, and death. Complication rates for needle pericardiocentesis are increased in situations where the pericardial space and fluid effusion volume is small (i.e. the pericardial size is more like normal and not abnormally distended by the accumulation of fluid, e.g., blood).
  • U.S. Patent No. 5,071,428 discloses a method and apparatus for accessing the pericardial space for the insertion of implantable defibrillation leads. This method requires griping the pericardium with a forceps device and cutting the pericardium with a scalpel (pericardiotomy) under direct vision through a subxiphoid surgical incision.
  • Another method for intrapericardial injection of agents is performed by a device, available under the name PerDUCERTM pericardial access device, available from Comedicus Incorporated, 3839 Central Avenue, NE, Columbia Heights, Minnesota 55421.
  • This device creates a lifted section of the pericardium, known as a "bleb" through suction.
  • the bleb is secured in an instrument end by suction, and the tissue forming the bleb in this end takes the shape of the instrument end.
  • the bleb is then punctured by a needle of limited travel, and a guidewire is inserted into the bleb.
  • a fluid infusion catheter is then moved over the guidewire, for example, to aspirate fluids from or deliver therapeutic drugs to the pericardium, pericardial space or heart muscle, via the bleb.
  • the present invention provides an alternate method of manually creating a controlled bleb.
  • the present invention allows for safe access to the pericardial space without injury to the heart, in order to aspirate fluids directly from or to directly deliver fluids, i.e., therapeutic drugs, to the heart muscle. With such safe access to the heart, complications from contacting the heart muscle are greatly reduced and nearly eliminated. Additionally, by directly delivering drugs to the heart muscle via the pericardium (pericardial sac), side affects associated with drug delivery by conventional administration methods, i.e., oral or injection, can be reduced, such that lesser dosages are needed to achieve the desired effect of a specific drug. Moreover, this direct method of drug delivery allows for a wider range of drugs to be used.
  • the apparatus of the present invention includes a shaft with a first distal end and a second proximal end.
  • a bore extends through the shaft from the distal end to the proximal end.
  • the first end includes jaws, that open and close, as at least one of the jaws is movable.
  • the second end includes a handle, at least a portion of the handle in communication with a mechanism in communication with the movable jaw, such that upon movement of at least a portion of the handle, the jaws can be opened and closed at will and to any desired degree.
  • a needle, for puncturing tissue e.g., a bleb of pericardium tissue
  • grasped within the jaws is movably mounted within the bore and is in communication with a mechanism for limiting its travel with respect to the bore.
  • the present invention additionally includes a method for mechanically creating a bleb of pericardium tissue, with the apparatus of the present invention, and subsequently accessing the pericardial space.
  • This access includes the use of guidewires, catheters, and other instrumentation.
  • FIG. 1 is a side view and with a partial cross-sectional view of the apparatus of the present invention
  • FIG. 2 is a cross-sectional view of the apparatus of the present invention taken along line 2-2 of FIG. 1;
  • FIG. 3 is a is a perspective view of the first or distal and of the apparatus with the jaws closed;
  • FIG. 4 is a cross-sectional view of the apparatus of the present invention taken along line 4-4 of FIG. 1;
  • FIG. 5 is a perspective view of the first or distal and of the apparatus with the jaws open.
  • FIGs. 6A-6E are perspective views detailing the apparatus of the present invention performing the method of the present invention.
  • FIGs. 1-5 detail the apparatus 20 of the present invention.
  • the apparatus includes a body 22 having a shaft 24 with jaws 26, 27 at a first or distal end 28 and a handle 30, at a second or proximal end 31 , the handle 30 formed of a movable arm 32 and a fixed arm 33.
  • the shaft 24 has a bore 34 extending therethrough, with distal 36 and proximal 37 portions, to accommodate a needle 38 and additional structures for fluid aspiration or infusion (detailed below) from or to the pericardial space 101 (FIGs. 6A-6E).
  • a first jaw 26 and a second jaw 27 are at the first end 28 of the shaft
  • the hinge 40 is preferably an arc-like piece, of a curvature conforming to that of the bore 34, and attaches by a pin 44 or the like at a second pivot point 44a to a rod 46.
  • the second pivot point 44a moves within a well 48, cut into the body 22 of the shaft 24.
  • the rod 46 terminates in a flange 50, piviotally mounted to the movable arm 32 at by a pin 51 at a pivot point 51a.
  • Movement from the movable arm 32 moves the rod 46 (forward, toward the first end 28 of the shaft 24, or backward, toward the second end 34 of the shaft 24) within the bore 34, to ultimately move the jaws 26, 27 between the closed and open positions (in the direction of the arrow 42), to the degree desired by the operator.
  • the jaws 26, 27 include cooperatingly arranged, preferably correspondingly configured, teeth 52, 53, in order to assist the jaws 26, 27, when brought together, to sufficiently grasp and retain tissue (i.e., the tissue of the pericardium, also known as the pericardial sac, forming the bleb).
  • the teeth 52, 53 are preferably of a uniform pitch (as shown in the drawing figures) for the entire length of their respective jaws 26, 27, but could be of different pitches provided they remain cooperatingly arranged on each jaw 26, 27 and that the jaws 26, 27 remain able to close completely (FIG. 3).
  • the jaws 26, 27 also include grooves 54, 55, for assisting in the gripping and traction on the tissue of the bleb without damaging it, as well as accommodating the needle and other related instrumentation, as discussed below. Additionally, it is preferred that the jaws 26, 27 be shaped such that upon incomplete closure (e.g., during the grasping and retaining of tissue) or complete closure (e.g., when the apparatus 20 is being moved into the body), there is a cavity 58 between them, for receiving tissue of the pericardium.
  • the second end 32 of the shaft 24 is formed of the movable 32 and fixed 33 arms.
  • the fixed arm 33 extends from the body 22 at an angle (approximately 60 degrees). Both arms 32, 33 terminate in loops 60, 61, to accommodate the fingers of an operator. While loops 60, 61 are preferred, other equivalent structures, such as crescent-shaped members or the like are also permissible.
  • the movable arm 32 is piviotally mounted to the body 22 of the shaft
  • this movable arm be rounded, so as to allow for movement (toward the distal 28 and proximal ends 32 of the shaft 24) of the movable arm 32 in the direction of the arrow 67, as the movable arm 32 is free to travel within a space 68 in the body 22 of the shaft. Travel of the movable arm 32 is confined to this space 68, by the abutment of the surface 69 of the body 22 and the surface of the movable arm 70, and the fixed arm 33.
  • the flange 50 be on one side of the bore 36, while the portion of the movable arm 32 within the body 22 be on the other side, so as to straddle the needle 38 or other instrumentation in the bore 34, as shown in detail in FIG. 4. It is also preferred that portions of the flange 50 and movable arm 32 within the body 22, be of a diameter as close as possible to that of the bore 34, to allow for unobstructed passage of the needle 38 or other instrumentation through the bore 34.
  • the movable arm 32 is preferably not biased, such that the ultimate position of the jaws 26, 27 (open or closed, as desired by the operator) depends on the position of the movable arm 32.
  • the movable arm 32, hinge 40, rod 46 or flange 50 may be biased by springs or other equivalent mechanisms, such that the jaws 26, 27 are either open or closed when the apparatus 20 is not in use.
  • the shaft 24, jaws, 26, 27 handle 30 and components controlling the movement of the jaws 26, 27 are preferably made of titanium, stainless steel or the like. Plastics, such as polycarbonate, polyamide, acrylonitrile/butadiene/styrene (ABS) copolymers, or the like, can also be used.
  • the body 22 is preferably tubular in shape and the bore 34, is preferably circular in cross section.
  • the proximal portion 37 of the bore 34 is of a diameter greater than that of the distal portion 36 of the bore 34.
  • distal 36 and proximal 37 portions are designed to accommodate the needle 38, needle trigger 78 (in the proximal portion 37 of the bore 34), guidewire(s) 82, catheter(s) 108 (FIGs. 6D and 6E) and other instrumentation that can be inserted into and moved through the bore 34.
  • the needle 38 is designed to extend past the jaws 26, 27 of the body 22 during use (if desired) (FIG. 5). However, movement of the needle is restricted by a needle trigger 78, preferably biased by a spring (not shown) that journals at least a portion of the needle 38 in the proximal portion 37 of the bore 34.
  • the distal wall 73 of the proximal portion 37 of the bore 34 limits the travel of the needle trigger 78 (when it is activated by the operator), that ultimately limits the length of travel of the needle 38 in puncturing the bleb 104 (FIGs. 6B-6E).
  • the needle 38 is typically made of stainless steel or titanium and includes a beveled end 80, in order to produce a sharp precise puncture of the bleb 104.
  • the needle is of a diameter less than that of the distal 36 and proximal portions of the bore 34, to slide within the bore 34, and is typically of a diameter of approximately 21 gauge (approximately .813 mm in diameter).
  • the needle trigger 78 that surrounds a portion of the needle 38 is preferably made of TEFLON®, and is designed to slide within the proximal portion 37 of the bore 34.
  • the needle 38 is preferably hollow, to accommodate guidewires 82, catheters 108 (FIGs.
  • catheter sheaths catheter sheath introducers and other cannulation devices, to be moved (slid) through the needle 38 or the bore 34 (if the needle 38 has been removed), in order to, for example, aspirate fluid from the pericardial sac 101 (FIGs. 6A-6E) or deliver fluid, such as therapeutic drugs, to the pericardial sac 101.
  • FIGs. 6A-6E there is shown the apparatus 20 of the present invention in use for accessing the pericardium 100, and entering the pericardial space 101 surrounding the heart 102.
  • a subxiphoid incision is made in the chest cavity of a patient.
  • a standard mediastinscopy endoscope is inserted into this incision for direct vision and the apparatus 20 of the present invention is inserted through the endoscope.
  • the apparatus 20 of the present invention is inserted through the endoscope.
  • the operator advances the movable arm 32 (FIG. 1) of the apparatus 20 toward the first or distal end 28 (FIG. 1) of the shaft 24 (FIG. 1), moving the jaw 27, and thus, opening the jaws 26, 27.
  • Pericardium 100 tissue as a result of back pressure exerted thereon, by the fluid in the pericardial space 101, now fills the cavity 58 (FIG. 1) between the jaws 26, 27 and the teeth 52, 53 (FIGs.
  • the operator can move the apparatus 20 holding the bleb 104, in a direction away from the heart 102, to increase the size of the bleb 104.
  • the operator activates the needle trigger 78, advancing the needle 38 toward the distal end 28 of the shaft 24 into the bleb
  • the guidewire 82 is advanced through the needle 38 into the pericardial space 101 (FIG. 6C). With the guidewire 82 now advanced into the pericardial space 101, a fluid retrieving or delivering catheter 108 can now be advanced over the guidewire 82 (in the direction of the arrow 110), as shown in FIG. 6D.
  • Advancement of the catheter 108 continues simultaneous with withdrawal of the guidewire 82 (in the direction of arrow 111) until the catheter 108 is properly positioned within the pericardial space 101, as shown in FIG. 6E.
  • This catheter 108 allows for fluid aspiration directly from or fluid (e.g., drugs, therapeutic agents or the like) delivery directly into the pericardial space 101.
  • fluid delivery there is provided a direct route for treating the heart 102 and associated coronary vessels 112.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Ophthalmology & Optometry (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

L'invention a trait à un appareil, ainsi qu'à la technique correspondante, permettant de former une boursouflure dans le tissu péricardique et ce, afin d'accéder à l'espace péricardique, intermédiaire entre le péricarde et le coeur, pour retirer ou introduire un fluide, des médicaments, des agents thérapeutiques ou analogue. L'appareil de l'invention comporte une tige ayant une extrémité distale et une seconde extrémité proximale, qu'un alésage traverse, de l'extrémité distale à l'extrémité proximale. La première extrémité est pourvue de mâchoires, s'ouvrant et se fermant, l'une d'elles au moins étant mobile. La seconde extrémité est pourvue d'un organe de commande, dont un élément au moins est en communication avec la mâchoire mobile, de telle sorte que le mouvement d'au moins un élément de l'organe de commande fait que les mâchoires s'ouvrent et se ferment sans interruption. Une aiguille, destinée à perforer la boursouflure de tissu prise dans les mâchoires, loge, de manière à pouvoir se déplacer, dans l'alésage et est tributaire d'un mécanisme servant à limiter son déplacement relativement audit alésage.
PCT/US1997/022129 1996-12-05 1997-12-05 Appareil permettant d'acceder a l'espace pericardique et technique correspondante Ceased WO1998024378A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
EP97950804A EP0952788A1 (fr) 1996-12-05 1997-12-05 Appareil permettant d'acceder a l'espace pericardique et technique correspondante
AU53704/98A AU744703B2 (en) 1996-12-05 1997-12-05 Apparatus and method for accessing the pericardial space
CA002273948A CA2273948A1 (fr) 1996-12-05 1997-12-05 Appareil permettant d'acceder a l'espace pericardique et technique correspondante
JP52576798A JP2001505464A (ja) 1996-12-05 1997-12-05 心膜空隙にアクセスする装置及び方法

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US08/761,189 US5931810A (en) 1996-12-05 1996-12-05 Method for accessing the pericardial space
US08/761,189 1996-12-05

Publications (1)

Publication Number Publication Date
WO1998024378A1 true WO1998024378A1 (fr) 1998-06-11

Family

ID=25061445

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1997/022129 Ceased WO1998024378A1 (fr) 1996-12-05 1997-12-05 Appareil permettant d'acceder a l'espace pericardique et technique correspondante

Country Status (6)

Country Link
US (2) US5931810A (fr)
EP (1) EP0952788A1 (fr)
JP (1) JP2001505464A (fr)
AU (1) AU744703B2 (fr)
CA (1) CA2273948A1 (fr)
WO (1) WO1998024378A1 (fr)

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6569082B1 (en) 1999-08-10 2003-05-27 Origin Medsystems, Inc. Apparatus and methods for cardiac restraint
US6685672B1 (en) 2000-07-13 2004-02-03 Edwards Lifesciences Corporation Multi-balloon drug delivery catheter for angiogenesis
US6692458B2 (en) 2000-12-19 2004-02-17 Edwards Lifesciences Corporation Intra-pericardial drug delivery device with multiple balloons and method for angiogenesis
US7214180B2 (en) 1999-08-10 2007-05-08 Origin Medsystems, Inc. Method for cardiac restraint
US7288096B2 (en) 2003-01-17 2007-10-30 Origin Medsystems, Inc. Apparatus for placement of cardiac defibrillator and pacer
US7526342B2 (en) 1999-08-10 2009-04-28 Maquet Cardiovascular Llc Apparatus for endoscopic cardiac mapping and lead placement
US7597698B2 (en) 1999-08-10 2009-10-06 Maquet Cardiovascular Llc Apparatus and method for endoscopic encirclement of pulmonary veins for epicardial ablation
EP1525852A4 (fr) * 2002-06-21 2010-02-03 Vayu Kk Catheter
WO2011043126A1 (fr) 2009-10-06 2011-04-14 オリンパス株式会社 Dispositif de guidage
US8348891B2 (en) 2009-09-22 2013-01-08 Olympus Corporation Surgical method and medical device
US8808173B2 (en) 2009-09-22 2014-08-19 Olympus Corporation Space ensuring device
US8900123B2 (en) 2009-03-02 2014-12-02 Olympus Corporation Endoscopy method and endoscope
CN104602627A (zh) * 2012-11-13 2015-05-06 奥林巴斯株式会社 医疗器件
US9393023B2 (en) 2009-01-13 2016-07-19 Atricure, Inc. Apparatus and methods for deploying a clip to occlude an anatomical structure

Families Citing this family (203)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6161543A (en) 1993-02-22 2000-12-19 Epicor, Inc. Methods of epicardial ablation for creating a lesion around the pulmonary veins
US5897553A (en) 1995-11-02 1999-04-27 Medtronic, Inc. Ball point fluid-assisted electrocautery device
US6409722B1 (en) 1998-07-07 2002-06-25 Medtronic, Inc. Apparatus and method for creating, maintaining, and controlling a virtual electrode used for the ablation of tissue
US6283951B1 (en) 1996-10-11 2001-09-04 Transvascular, Inc. Systems and methods for delivering drugs to selected locations within the body
NL1003024C2 (nl) 1996-05-03 1997-11-06 Tjong Hauw Sie Prikkelgeleidingsblokkeringsinstrument.
US6237605B1 (en) 1996-10-22 2001-05-29 Epicor, Inc. Methods of epicardial ablation
US7052493B2 (en) 1996-10-22 2006-05-30 Epicor Medical, Inc. Methods and devices for ablation
US6311692B1 (en) 1996-10-22 2001-11-06 Epicor, Inc. Apparatus and method for diagnosis and therapy of electrophysiological disease
US6719755B2 (en) 1996-10-22 2004-04-13 Epicor Medical, Inc. Methods and devices for ablation
US6805128B1 (en) 1996-10-22 2004-10-19 Epicor Medical, Inc. Apparatus and method for ablating tissue
US6840936B2 (en) 1996-10-22 2005-01-11 Epicor Medical, Inc. Methods and devices for ablation
US6096037A (en) 1997-07-29 2000-08-01 Medtronic, Inc. Tissue sealing electrosurgery device and methods of sealing tissue
US20120179182A1 (en) * 1997-08-14 2012-07-12 United States Surgical Corporation Ultrasonic curved blade
US6592552B1 (en) * 1997-09-19 2003-07-15 Cecil C. Schmidt Direct pericardial access device and method
US8709007B2 (en) 1997-10-15 2014-04-29 St. Jude Medical, Atrial Fibrillation Division, Inc. Devices and methods for ablating cardiac tissue
US5997509A (en) * 1998-03-06 1999-12-07 Cornell Research Foundation, Inc. Minimally invasive gene therapy delivery device and method
US6527767B2 (en) * 1998-05-20 2003-03-04 New England Medical Center Cardiac ablation system and method for treatment of cardiac arrhythmias and transmyocardial revascularization
AU762622B2 (en) 1998-05-26 2003-07-03 Comedicus, Incorporated Intrapericardial procedures and apparatuses
US6537248B2 (en) 1998-07-07 2003-03-25 Medtronic, Inc. Helical needle apparatus for creating a virtual electrode used for the ablation of tissue
US6706039B2 (en) 1998-07-07 2004-03-16 Medtronic, Inc. Method and apparatus for creating a bi-polar virtual electrode used for the ablation of tissue
US8308719B2 (en) 1998-09-21 2012-11-13 St. Jude Medical, Atrial Fibrillation Division, Inc. Apparatus and method for ablating tissue
US6245062B1 (en) 1998-10-23 2001-06-12 Afx, Inc. Directional reflector shield assembly for a microwave ablation instrument
JP3708356B2 (ja) * 1998-11-20 2005-10-19 株式会社モリタ製作所 組織採取切除器及びこれに使用する切除用鉗子
JP3615960B2 (ja) * 1999-04-14 2005-02-02 ペンタックス株式会社 内視鏡用針付生検鉗子
US7226446B1 (en) 1999-05-04 2007-06-05 Dinesh Mody Surgical microwave ablation assembly
US6277113B1 (en) 1999-05-28 2001-08-21 Afx, Inc. Monopole tip for ablation catheter and methods for using same
EP1207788A4 (fr) 1999-07-19 2009-12-09 St Jude Medical Atrial Fibrill Techniques d'ablation de tissus et dispositif correspondant
US20030187460A1 (en) * 1999-08-10 2003-10-02 Chin Albert K. Methods and apparatus for endoscopic cardiac surgery
US7264587B2 (en) * 1999-08-10 2007-09-04 Origin Medsystems, Inc. Endoscopic subxiphoid surgical procedures
US20050154370A1 (en) 1999-10-29 2005-07-14 Medtronic, Inc. Methods and systems for providing therapies into the pericardial space
US7758521B2 (en) * 1999-10-29 2010-07-20 Medtronic, Inc. Methods and systems for accessing the pericardial space
US20040121942A1 (en) * 1999-11-02 2004-06-24 Kenneth Chien Method for inhibition of phospholamban activity for the treatment of cardiac disease and heart failure
AU4523301A (en) * 1999-12-14 2001-06-25 Radiant Medical, Inc. Method for reducing myocardial infarct by applicaton of intravascular hypothermia
US6685716B1 (en) * 2000-01-04 2004-02-03 Transvascular, Inc. Over-the-wire apparatus and method for open surgery making of fluid connection between two neighboring vessels
US7033352B1 (en) 2000-01-18 2006-04-25 Afx, Inc. Flexible ablation instrument
US6447443B1 (en) 2001-01-13 2002-09-10 Medtronic, Inc. Method for organ positioning and stabilization
US8241274B2 (en) 2000-01-19 2012-08-14 Medtronic, Inc. Method for guiding a medical device
US6692450B1 (en) 2000-01-19 2004-02-17 Medtronic Xomed, Inc. Focused ultrasound ablation devices having selectively actuatable ultrasound emitting elements and methods of using the same
US8221402B2 (en) 2000-01-19 2012-07-17 Medtronic, Inc. Method for guiding a medical device
US7706882B2 (en) 2000-01-19 2010-04-27 Medtronic, Inc. Methods of using high intensity focused ultrasound to form an ablated tissue area
US6478769B1 (en) * 2000-02-22 2002-11-12 The Board Of Trustees Of The University Of Arkansas Anatomical fluid evacuation apparatus and method
US8048070B2 (en) 2000-03-06 2011-11-01 Salient Surgical Technologies, Inc. Fluid-assisted medical devices, systems and methods
US6673068B1 (en) 2000-04-12 2004-01-06 Afx, Inc. Electrode arrangement for use in a medical instrument
US6514250B1 (en) 2000-04-27 2003-02-04 Medtronic, Inc. Suction stabilized epicardial ablation devices
US6932811B2 (en) * 2000-04-27 2005-08-23 Atricure, Inc. Transmural ablation device with integral EKG sensor
US6558382B2 (en) * 2000-04-27 2003-05-06 Medtronic, Inc. Suction stabilized epicardial ablation devices
US20020107514A1 (en) 2000-04-27 2002-08-08 Hooven Michael D. Transmural ablation device with parallel jaws
US6488680B1 (en) 2000-04-27 2002-12-03 Medtronic, Inc. Variable length electrodes for delivery of irrigated ablation
EP1278471B1 (fr) 2000-04-27 2005-06-15 Medtronic, Inc. Appareil d'ablation sensible aux vibrations
US6425856B1 (en) 2000-05-10 2002-07-30 Acorn Cardiovascular, Inc. Cardiac disease treatment and device
US6726920B1 (en) 2000-09-22 2004-04-27 Durect Corporation Implantable drug delivery patch
US6926669B1 (en) 2000-10-10 2005-08-09 Medtronic, Inc. Heart wall ablation/mapping catheter and method
US20020087151A1 (en) 2000-12-29 2002-07-04 Afx, Inc. Tissue ablation apparatus with a sliding ablation instrument and method
US7740623B2 (en) 2001-01-13 2010-06-22 Medtronic, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US6890295B2 (en) * 2002-10-31 2005-05-10 Medtronic, Inc. Anatomical space access tools and methods
US7628780B2 (en) 2001-01-13 2009-12-08 Medtronic, Inc. Devices and methods for interstitial injection of biologic agents into tissue
US6837848B2 (en) * 2003-01-15 2005-01-04 Medtronic, Inc. Methods and apparatus for accessing and stabilizing an area of the heart
US20040138621A1 (en) 2003-01-14 2004-07-15 Jahns Scott E. Devices and methods for interstitial injection of biologic agents into tissue
US6786898B2 (en) * 2003-01-15 2004-09-07 Medtronic, Inc. Methods and tools for accessing an anatomic space
US6663627B2 (en) 2001-04-26 2003-12-16 Medtronic, Inc. Ablation system and method of use
US6699240B2 (en) 2001-04-26 2004-03-02 Medtronic, Inc. Method and apparatus for tissue ablation
US6807968B2 (en) 2001-04-26 2004-10-26 Medtronic, Inc. Method and system for treatment of atrial tachyarrhythmias
US7250048B2 (en) 2001-04-26 2007-07-31 Medtronic, Inc. Ablation system and method of use
US7959626B2 (en) 2001-04-26 2011-06-14 Medtronic, Inc. Transmural ablation systems and methods
US6648883B2 (en) 2001-04-26 2003-11-18 Medtronic, Inc. Ablation system and method of use
JP4838945B2 (ja) * 2001-05-10 2011-12-14 オリンパス株式会社 内視鏡用処置具および内視鏡用処置具の操作部
JP2003007916A (ja) * 2001-06-19 2003-01-10 Sanyo Electric Co Ltd 回路装置の製造方法
US20030093105A1 (en) * 2001-07-13 2003-05-15 Scimed Life Systems, Inc. Guide catheter for introduction into the subarachnoid space and methods of use thereof
US7455666B2 (en) * 2001-07-13 2008-11-25 Board Of Regents, The University Of Texas System Methods and apparatuses for navigating the subarachnoid space
US7011647B2 (en) * 2001-07-13 2006-03-14 Scimed Life Systems, Inc. Introducer sheath
US7150737B2 (en) 2001-07-13 2006-12-19 Sci/Med Life Systems, Inc. Methods and apparatuses for navigating the subarachnoid space
EP2275050A1 (fr) 2001-09-05 2011-01-19 Salient Surgical Technologies, Inc. Dispositifs, procédés et systèmes chirurgicaux assistés par un fluide
DE60227676D1 (de) 2001-09-07 2008-08-28 Mardil Inc Verfahren und gerät für die externe herzstabilisierung
US6656175B2 (en) 2001-12-11 2003-12-02 Medtronic, Inc. Method and system for treatment of atrial tachyarrhythmias
US7099717B2 (en) 2002-01-03 2006-08-29 Afx Inc. Catheter having improved steering
US6827715B2 (en) 2002-01-25 2004-12-07 Medtronic, Inc. System and method of performing an electrosurgical procedure
US7967816B2 (en) 2002-01-25 2011-06-28 Medtronic, Inc. Fluid-assisted electrosurgical instrument with shapeable electrode
US7192427B2 (en) 2002-02-19 2007-03-20 Afx, Inc. Apparatus and method for assessing transmurality of a tissue ablation
US6929630B2 (en) * 2002-05-07 2005-08-16 Baylor College Of Medicine Infusion clamp
US7294143B2 (en) 2002-05-16 2007-11-13 Medtronic, Inc. Device and method for ablation of cardiac tissue
US7118566B2 (en) 2002-05-16 2006-10-10 Medtronic, Inc. Device and method for needle-less interstitial injection of fluid for ablation of cardiac tissue
US7083620B2 (en) 2002-10-30 2006-08-01 Medtronic, Inc. Electrosurgical hemostat
US20040138521A1 (en) * 2003-01-10 2004-07-15 Grabek James R. Myocardial constraint
US7883500B2 (en) * 2003-03-26 2011-02-08 G&L Consulting, Llc Method and system to treat and prevent myocardial infarct expansion
JP4698128B2 (ja) * 2003-03-28 2011-06-08 テルモ株式会社 穿刺センサを有するカテーテル
US20040199154A1 (en) * 2003-04-02 2004-10-07 Cryocath Technologies Inc. Device for tissue ablation
US7497857B2 (en) 2003-04-29 2009-03-03 Medtronic, Inc. Endocardial dispersive electrode for use with a monopolar RF ablation pen
DE10337813A1 (de) * 2003-08-14 2005-03-10 Transmit Technologietransfer Vorrichtung für eine Gewebe- und Organmanipulation
US7186214B2 (en) * 2004-02-12 2007-03-06 Medtronic, Inc. Instruments and methods for accessing an anatomic space
AU2005232665B2 (en) * 2004-04-08 2010-05-13 Sangamo Therapeutics, Inc. Methods and compositions for treating neuropathic and neurodegenerative conditions
EP1732945B1 (fr) * 2004-04-08 2014-12-24 Sangamo BioSciences, Inc. Procedes et compositions pour moduler la contractilite cardiaque
US20050234507A1 (en) * 2004-04-16 2005-10-20 Jeff Geske Medical tool for access to internal tissue
US8333764B2 (en) 2004-05-12 2012-12-18 Medtronic, Inc. Device and method for determining tissue thickness and creating cardiac ablation lesions
ES2308505T3 (es) 2004-05-14 2008-12-01 Medtronic, Inc. Sistema de utilizacion de energia ultrasonica enfocada de alta intens idad para formar una zona de tejido recortado.
EP1750606B1 (fr) 2004-06-02 2010-05-05 Medtronic, Inc. Dispositif d'ablation bipolaire d'un compose
WO2005120375A2 (fr) 2004-06-02 2005-12-22 Medtronic, Inc. Appareil et methode d'ablation a boucle
WO2005120377A1 (fr) 2004-06-02 2005-12-22 Medtronic, Inc. Outil d'ablation et de clampage
EP1750608B1 (fr) 2004-06-02 2012-10-03 Medtronic, Inc. Dispositif d'ablation comprenant des machoires
US8409219B2 (en) 2004-06-18 2013-04-02 Medtronic, Inc. Method and system for placement of electrical lead inside heart
US8663245B2 (en) 2004-06-18 2014-03-04 Medtronic, Inc. Device for occlusion of a left atrial appendage
US8926635B2 (en) * 2004-06-18 2015-01-06 Medtronic, Inc. Methods and devices for occlusion of an atrial appendage
SE0401880D0 (sv) * 2004-07-19 2004-07-19 Q Med Ab An arrangement and a method for injection of a substance into a body organ
US7727163B2 (en) * 2004-09-27 2010-06-01 Percutaneous Systems, Inc. Methods and apparatus for hollow body structure resection
US7618410B2 (en) * 2004-10-05 2009-11-17 Cardia Access, Inc. Devices and methods for access through a tissue wall
US20060259017A1 (en) * 2005-04-27 2006-11-16 Cardiac Pacemakers, Inc. Adhesive elements and methods for accessing the pericardial space
US8932208B2 (en) 2005-05-26 2015-01-13 Maquet Cardiovascular Llc Apparatus and methods for performing minimally-invasive surgical procedures
US20070010793A1 (en) 2005-06-23 2007-01-11 Cardiac Pacemakers, Inc. Method and system for accessing a pericardial space
US20070014784A1 (en) 2005-06-23 2007-01-18 Medtronic Vascular, Inc. Methods and Systems for Treating Injured Cardiac Tissue
CN101563097A (zh) 2005-11-14 2009-10-21 企业合伙人风险资本公司 用于组织损伤的干细胞生长因子疗法
US20070135686A1 (en) * 2005-12-14 2007-06-14 Pruitt John C Jr Tools and methods for epicardial access
US20070208217A1 (en) 2006-03-03 2007-09-06 Acorn Cardiovascular, Inc. Self-adjusting attachment structure for a cardiac support device
US8244379B2 (en) * 2006-04-26 2012-08-14 Medtronic, Inc. Pericardium fixation concepts of epicardium pacing leads and tools
US20070270654A1 (en) 2006-05-19 2007-11-22 Acorn Cardiovascular, Inc. Pericardium management tool for intra-pericardial surgical procedures
US20080039746A1 (en) 2006-05-25 2008-02-14 Medtronic, Inc. Methods of using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions
US20080097146A1 (en) 2006-06-29 2008-04-24 Acorn Cardiovascular, Inc. Cardiac support device with low friction delivery structures
US7651462B2 (en) 2006-07-17 2010-01-26 Acorn Cardiovascular, Inc. Cardiac support device delivery tool with release mechanism
US20080045859A1 (en) * 2006-08-19 2008-02-21 Fritsch Michael H Devices and Methods for In-Vivo Pathology Diagnosis
US7641608B1 (en) 2006-09-26 2010-01-05 Acorn Cardiovascular, Inc. Sectional cardiac support device and method of delivery
DE102006058447A1 (de) * 2006-12-10 2008-06-19 Philipps-Universität Marburg Vorrichtung zur Fixierung und Manipulation von organischen oder anorganischen Geweben
US12035964B2 (en) 2007-12-27 2024-07-16 Boston Scientific Medical Device Limited Electrosurgical pericardial puncture
WO2008118737A1 (fr) * 2007-03-22 2008-10-02 University Of Virginia Patent Foundation Cathéter à électrode permettant d'effectuer une ablation et procédé associé
US10166066B2 (en) 2007-03-13 2019-01-01 University Of Virginia Patent Foundation Epicardial ablation catheter and method of use
US9468396B2 (en) 2007-03-19 2016-10-18 University Of Virginia Patent Foundation Systems and methods for determining location of an access needle in a subject
US11058354B2 (en) 2007-03-19 2021-07-13 University Of Virginia Patent Foundation Access needle with direct visualization and related methods
WO2008115745A2 (fr) * 2007-03-19 2008-09-25 University Of Virginia Patent Foundation Dispositif de détection de pression d'aiguille d'accès et son procédé d'utilisation
US8718746B2 (en) 2007-06-21 2014-05-06 Mardil, Inc. Pericardial space imaging for cardiac support device implantation
US8128592B2 (en) * 2007-07-11 2012-03-06 Apollo Endosurgery, Inc. Methods and systems for performing submucosal medical procedures
US20090036965A1 (en) * 2007-07-30 2009-02-05 Robert Glenmore Walsh Conjunctive stent therapy
US20090036875A1 (en) * 2007-07-30 2009-02-05 Robert Glenmore Walsh Cardiac tissue therapy
JP2010540160A (ja) 2007-10-05 2010-12-24 マッケ カーディオバスキュラー，エルエルシー 最小限に侵襲的な外科的処置のための装置および方法
US20100241185A1 (en) 2007-11-09 2010-09-23 University Of Virginia Patent Foundation Steerable epicardial pacing catheter system placed via the subxiphoid process
US8663321B2 (en) 2007-12-06 2014-03-04 L. Van Thomas Crisco Minimally invasive method for coronary bypass and other treatments
US8882756B2 (en) 2007-12-28 2014-11-11 Medtronic Advanced Energy Llc Fluid-assisted electrosurgical devices, methods and systems
US20090264897A1 (en) * 2008-03-18 2009-10-22 Wohl Daniel L Tonsil forceps
US8226665B2 (en) * 2008-04-04 2012-07-24 Tyco Healthcare Group Lp Ultrasonic needle driver
US8821488B2 (en) 2008-05-13 2014-09-02 Medtronic, Inc. Tissue lesion evaluation
US9254168B2 (en) 2009-02-02 2016-02-09 Medtronic Advanced Energy Llc Electro-thermotherapy of tissue using penetrating microelectrode array
WO2010096809A1 (fr) 2009-02-23 2010-08-26 Salient Surgical Technologies, Inc. Dispositif électrochirurgical assisté par un fluide et procédés pour l'utiliser
WO2010105081A1 (fr) 2009-03-13 2010-09-16 Medtronic, Inc. Procédé de traitement d'insuffisance cardiaque
US20100274129A1 (en) * 2009-04-24 2010-10-28 Hooven Michael D Apparatus And Methods for Separating Pericardial Tissue From The Epicardium of the Heart
WO2010127259A1 (fr) 2009-05-01 2010-11-04 University Of Virginia Patent Foundation Trocart d'accès et procédé lié à celui-ci
IN2012DN01917A (fr) 2009-09-08 2015-07-24 Salient Surgical Tech Inc
US9642534B2 (en) 2009-09-11 2017-05-09 University Of Virginia Patent Foundation Systems and methods for determining location of an access needle in a subject
EP2485638B1 (fr) 2009-10-07 2016-11-30 Endophys Holdings, LLC Dispositif médical de détection de pression
EP2537149B1 (fr) 2010-02-18 2017-10-25 University Of Virginia Patent Foundation Système, procédé et produit programme d'ordinateur pour la simulation de procédures d'électrophysiologie épicardiques
EP2544616B1 (fr) 2010-03-11 2017-09-06 Medtronic Advanced Energy LLC Instrument tranchant électrochirurgical bipolaire comprenant un contact d'électrode de référence indépendante de la position
US8535335B2 (en) * 2010-04-13 2013-09-17 Iucf-Hyu (Industry-University Cooperation Foundation Hanyang University) Needle-coupled parallel mechanism
US20110295249A1 (en) * 2010-05-28 2011-12-01 Salient Surgical Technologies, Inc. Fluid-Assisted Electrosurgical Devices, and Methods of Manufacture Thereof
US9138289B2 (en) 2010-06-28 2015-09-22 Medtronic Advanced Energy Llc Electrode sheath for electrosurgical device
US8920417B2 (en) 2010-06-30 2014-12-30 Medtronic Advanced Energy Llc Electrosurgical devices and methods of use thereof
US8906012B2 (en) 2010-06-30 2014-12-09 Medtronic Advanced Energy Llc Electrosurgical devices with wire electrode
US8346373B2 (en) 2010-08-03 2013-01-01 Medtronic, Inc. Method and apparatus for delivering a lead to a heart
JP2012075604A (ja) * 2010-09-30 2012-04-19 Olympus Corp 処置具
US9023040B2 (en) 2010-10-26 2015-05-05 Medtronic Advanced Energy Llc Electrosurgical cutting devices
JP5745837B2 (ja) * 2010-12-24 2015-07-08 オリンパス株式会社 処置具
US9427281B2 (en) 2011-03-11 2016-08-30 Medtronic Advanced Energy Llc Bronchoscope-compatible catheter provided with electrosurgical device
US8628552B2 (en) 2011-03-16 2014-01-14 Pacesetter, Inc. Apparatus and method for accessing an intrapericardial space
US20130090642A1 (en) * 2011-07-06 2013-04-11 Arqos Surgical, Inc. Laparscopic tissue morcellator systems and methods
US9750565B2 (en) 2011-09-30 2017-09-05 Medtronic Advanced Energy Llc Electrosurgical balloons
US8870864B2 (en) 2011-10-28 2014-10-28 Medtronic Advanced Energy Llc Single instrument electrosurgery apparatus and its method of use
US9039691B2 (en) 2012-06-29 2015-05-26 Covidien Lp Surgical forceps
US9072524B2 (en) 2012-06-29 2015-07-07 Covidien Lp Surgical forceps
WO2014059433A2 (fr) 2012-10-12 2014-04-17 Mardil, Inc. Système et procédé de traitemetn cardiaque
EP2967524B1 (fr) * 2013-03-11 2019-09-04 Mayo Foundation For Medical Education And Research Systèmes de modification péricardique pour traitement de l'insuffisance cardiaque
US9713492B2 (en) 2013-09-03 2017-07-25 Covidien Lp Switch assemblies for multi-function surgical instruments and surgical instruments incorporating the same
US9597141B2 (en) 2013-09-03 2017-03-21 Covidien Lp Switch assemblies for multi-function surgical instruments and surgical instruments incorporating the same
US9579117B2 (en) 2013-09-25 2017-02-28 Covidien Lp Multi-function surgical instruments
USD717954S1 (en) 2013-10-14 2014-11-18 Mardil, Inc. Heart treatment device
KR101656944B1 (ko) * 2013-10-16 2016-09-19 국립암센터 내시경용 주사장치
US10231776B2 (en) 2014-01-29 2019-03-19 Covidien Lp Tissue sealing instrument with tissue-dissecting electrode
US9974599B2 (en) 2014-08-15 2018-05-22 Medtronic Ps Medical, Inc. Multipurpose electrosurgical device
US10080605B2 (en) 2014-09-17 2018-09-25 Covidien Lp Deployment mechanisms for surgical instruments
US10039593B2 (en) 2014-09-17 2018-08-07 Covidien Lp Surgical instrument having a bipolar end effector assembly and a deployable monopolar assembly
US10039592B2 (en) 2014-09-17 2018-08-07 Covidien Lp Deployment mechanisms for surgical instruments
US9987076B2 (en) 2014-09-17 2018-06-05 Covidien Lp Multi-function surgical instruments
US9918785B2 (en) 2014-09-17 2018-03-20 Covidien Lp Deployment mechanisms for surgical instruments
US9814516B2 (en) 2014-11-17 2017-11-14 Covidien Lp Deployment mechanisms for multi-function surgical instruments
US9724153B2 (en) 2014-11-17 2017-08-08 Covidien Lp Deployment mechanisms for surgical instruments
US9687294B2 (en) 2014-11-17 2017-06-27 Covidien Lp Deployment mechanism for surgical instruments
US9687293B2 (en) 2014-11-17 2017-06-27 Covidien Lp Deployment mechanism for surgical instruments
US9814517B2 (en) 2014-11-17 2017-11-14 Covidien Lp Deployment mechanisms for multi-function surgical instruments
US9867656B2 (en) 2014-11-17 2018-01-16 Covidien Lp Multi-function surgical instruments
US10478245B2 (en) 2014-12-10 2019-11-19 Covidien Lp Energizable attachment for surgical devices
USD844138S1 (en) 2015-07-17 2019-03-26 Covidien Lp Handle assembly of a multi-function surgical instrument
USD844139S1 (en) 2015-07-17 2019-03-26 Covidien Lp Monopolar assembly of a multi-function surgical instrument
US11389227B2 (en) 2015-08-20 2022-07-19 Medtronic Advanced Energy Llc Electrosurgical device with multivariate control
US11051875B2 (en) 2015-08-24 2021-07-06 Medtronic Advanced Energy Llc Multipurpose electrosurgical device
RU2622368C2 (ru) * 2015-09-25 2017-06-14 Владимир Сергеевич Самойлов Устройство для доставки клея "Сульфакрилат" на линию степлерного шва и способ его использования
US10631840B2 (en) 2015-11-25 2020-04-28 Talon Medical, LLC Tissue engagement devices, systems, and methods
US10716612B2 (en) 2015-12-18 2020-07-21 Medtronic Advanced Energy Llc Electrosurgical device with multiple monopolar electrode assembly
US10537381B2 (en) 2016-02-26 2020-01-21 Covidien Lp Surgical instrument having a bipolar end effector assembly and a deployable monopolar assembly
US10098695B2 (en) 2016-03-10 2018-10-16 Mayo Foundation For Medical Education And Research Pericardial modification devices and methods
JP6815408B2 (ja) * 2016-09-27 2021-01-20 テルモ株式会社 心筋梗塞検出方法、心筋梗塞検出装置及び医療器具
RU2629045C1 (ru) * 2016-10-28 2017-08-24 Владимир Сергеевич Самойлов Способ одномоментной профилактики билиарного рефлюкса и протекции гастроэнтероанастомоза при выполнении минижелудочного шунтирования
US10194975B1 (en) 2017-07-11 2019-02-05 Medtronic Advanced Energy, Llc Illuminated and isolated electrosurgical apparatus
US11154348B2 (en) 2017-08-29 2021-10-26 Covidien Lp Surgical instruments and methods of assembling surgical instruments
US12023082B2 (en) 2017-10-06 2024-07-02 Medtronic Advanced Energy Llc Hemostatic thermal sealer
US11123132B2 (en) 2018-04-09 2021-09-21 Covidien Lp Multi-function surgical instruments and assemblies therefor
CN108523985B (zh) * 2018-04-23 2024-05-07 南微医学科技股份有限公司 一种多功能高频电切开刀
US10828756B2 (en) 2018-04-24 2020-11-10 Covidien Lp Disassembly methods facilitating reprocessing of multi-function surgical instruments
US20190328420A1 (en) 2018-04-30 2019-10-31 Sebastian Khairkhahan Pericardial space access device and method
CN110755139A (zh) * 2019-11-22 2020-02-07 无锡市第二人民医院 一种钳夹式心包穿刺装置
JP2024033297A (ja) * 2022-08-30 2024-03-13 テルモ株式会社 医療デバイス

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0417031A2 (fr) * 1989-09-08 1991-03-13 FOGARTY, Thomas J. Appareil et méthode d'accès intrapéricardique en vue de la mise en place d'électrodes
US5071428A (en) 1989-09-08 1991-12-10 Ventritex, Inc. Method and apparatus for providing intrapericardial access and inserting intrapericardial electrodes
US5336252A (en) * 1992-06-22 1994-08-09 Cohen Donald M System and method for implanting cardiac electrical leads
WO1995017919A1 (fr) * 1993-12-27 1995-07-06 Heartport, Inc. Dispositifs et methodes de thoracoscopie pour arreter le c×ur
US5496310A (en) * 1994-09-30 1996-03-05 Exconde; Primo D. Endoscopic cholangiogram guide instrument and method of use
EP0706781A2 (fr) * 1994-10-11 1996-04-17 LaserSurge, Inc. Dispositif à morceler
WO1996022056A1 (fr) * 1995-01-20 1996-07-25 Inbae Yoon Instrument polyvalent aux fins d'investigations endoscopiques, muni d'organes operatoires interchangeables
WO1996040368A1 (fr) * 1995-06-07 1996-12-19 Cormedics Corp. Appareil et procede permettant d'acceder a l'espace pericardique

Family Cites Families (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4003379A (en) * 1974-04-23 1977-01-18 Ellinwood Jr Everett H Apparatus and method for implanted self-powered medication dispensing
US3923060A (en) * 1974-04-23 1975-12-02 Jr Everett H Ellinwood Apparatus and method for implanted self-powered medication dispensing having timing and evaluator means
US4027510A (en) * 1974-05-15 1977-06-07 Siegfried Hiltebrandt Forceps
US4222380A (en) * 1977-12-02 1980-09-16 Olympus Optical Co., Ltd. Celiac injector
US4759348A (en) * 1981-09-28 1988-07-26 Cawood Charles David Endoscope assembly and surgical instrument for use therewith
DE3347671A1 (de) * 1983-12-31 1985-07-11 Richard Wolf Gmbh, 7134 Knittlingen Instrument zur entnahme von gewebeproben
EP0150245A1 (fr) * 1984-01-30 1985-08-07 Storz, Karl, Dr.med. h.c. Instrument pour endoscopie de contact
US5387419A (en) * 1988-03-31 1995-02-07 The University Of Michigan System for controlled release of antiarrhythmic agents
US4991578A (en) * 1989-04-04 1991-02-12 Siemens-Pacesetter, Inc. Method and system for implanting self-anchoring epicardial defibrillation electrodes
IT1251509B (it) * 1989-11-24 1995-05-16 Leonardo Cammilli Defibrillatore impiantabile con riconoscimento automatico della fibrillazione ventricolare, ad azione farmacologica
US5213570A (en) * 1990-12-14 1993-05-25 Mallinckrodt Medical, Inc. System and method for oxygenation of the pericardium
US5249574A (en) * 1991-01-15 1993-10-05 Ventritex, Inc. Implantation of leads
US5071412A (en) * 1991-03-01 1991-12-10 Laparomed Corporation Device and method for performing cholangiography
DE4114311A1 (de) * 1991-05-02 1992-11-12 Harald Heidmueller Extraktor
US5235966A (en) * 1991-10-17 1993-08-17 Jay Jamner Endoscopic retractor
US5290299A (en) * 1991-12-11 1994-03-01 Ventritex, Inc. Double jaw apparatus for attaching implanted materials to body tissue
US5318589A (en) * 1992-04-15 1994-06-07 Microsurge, Inc. Surgical instrument for endoscopic surgery
US6059750A (en) * 1996-08-01 2000-05-09 Thomas J. Fogarty Minimally invasive direct cardiac massage device and method

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0417031A2 (fr) * 1989-09-08 1991-03-13 FOGARTY, Thomas J. Appareil et méthode d'accès intrapéricardique en vue de la mise en place d'électrodes
US5071428A (en) 1989-09-08 1991-12-10 Ventritex, Inc. Method and apparatus for providing intrapericardial access and inserting intrapericardial electrodes
US5336252A (en) * 1992-06-22 1994-08-09 Cohen Donald M System and method for implanting cardiac electrical leads
WO1995017919A1 (fr) * 1993-12-27 1995-07-06 Heartport, Inc. Dispositifs et methodes de thoracoscopie pour arreter le c×ur
US5496310A (en) * 1994-09-30 1996-03-05 Exconde; Primo D. Endoscopic cholangiogram guide instrument and method of use
EP0706781A2 (fr) * 1994-10-11 1996-04-17 LaserSurge, Inc. Dispositif à morceler
WO1996022056A1 (fr) * 1995-01-20 1996-07-25 Inbae Yoon Instrument polyvalent aux fins d'investigations endoscopiques, muni d'organes operatoires interchangeables
WO1996040368A1 (fr) * 1995-06-07 1996-12-19 Cormedics Corp. Appareil et procede permettant d'acceder a l'espace pericardique

Non-Patent Citations (8)

* Cited by examiner, † Cited by third party
Title
"Conc. Pericardium", GRAYS ANATOMY, 1 January 1977 (1977-01-01), pages 457-460
BISHOP L.H. ET AL: "The Electrocardiogram as a Safeguard in Pericardiocentesis", JAMA, vol. 162, 1 January 1956 (1956-01-01), pages 264
GOLDBERG B.B. ET AL.: "Ultrasonically Guided Pericardiocentesis", AM: J. CARDIOL., vol. 31, no. 490, 1 January 1973 (1973-01-01)
GOTSMAN M.S. ET AL: "A Perdicardiocentesis Electrode Needle", BR. HEART J., no. 28, 1 January 1966 (1966-01-01), pages 566
KERBER R.E. ET AL.: "Electrocardiographic Indications of Atrial Puncture During Pericardiocentesis", THE NEW ENGLAND JOURNAL OF MEDICINE, vol. 282, no. 1142, 1 January 1970 (1970-01-01)
NEILL J.R. ET AL: "A Pericardiocentesis Electrode", THE NEW ENGLAND JOURNAL OF MEDICINE, no. 264, 1 January 1961 (1961-01-01), pages 711
SHABETAI R.: "Pericardial and Cardiac Pressure", CIRCULATION, vol. 77, no. 1, 1 January 1988 (1988-01-01)
UCHIDA Y. ET AL: "Angiogenic Therapy of Acute Myocardial Infarction by Intraperi cardial Injection of Basic Fibroblast Growth Factor and Heparin Sulfate.", CIRCULATION AHA ABSTRACTS, 1 January 1994 (1994-01-01)

Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7597698B2 (en) 1999-08-10 2009-10-06 Maquet Cardiovascular Llc Apparatus and method for endoscopic encirclement of pulmonary veins for epicardial ablation
US6569082B1 (en) 1999-08-10 2003-05-27 Origin Medsystems, Inc. Apparatus and methods for cardiac restraint
US7214180B2 (en) 1999-08-10 2007-05-08 Origin Medsystems, Inc. Method for cardiac restraint
US7526342B2 (en) 1999-08-10 2009-04-28 Maquet Cardiovascular Llc Apparatus for endoscopic cardiac mapping and lead placement
US7398781B1 (en) 1999-08-10 2008-07-15 Maquet Cardiovascular, Llc Method for subxiphoid endoscopic access
US6997898B2 (en) 2000-07-13 2006-02-14 Edwards Lifesciences Corporation Multi-balloon drug delivery catheter for angiogenesis
US6685672B1 (en) 2000-07-13 2004-02-03 Edwards Lifesciences Corporation Multi-balloon drug delivery catheter for angiogenesis
US6692458B2 (en) 2000-12-19 2004-02-17 Edwards Lifesciences Corporation Intra-pericardial drug delivery device with multiple balloons and method for angiogenesis
EP1525852A4 (fr) * 2002-06-21 2010-02-03 Vayu Kk Catheter
US7288096B2 (en) 2003-01-17 2007-10-30 Origin Medsystems, Inc. Apparatus for placement of cardiac defibrillator and pacer
US9393023B2 (en) 2009-01-13 2016-07-19 Atricure, Inc. Apparatus and methods for deploying a clip to occlude an anatomical structure
US8900123B2 (en) 2009-03-02 2014-12-02 Olympus Corporation Endoscopy method and endoscope
US8348891B2 (en) 2009-09-22 2013-01-08 Olympus Corporation Surgical method and medical device
US8808173B2 (en) 2009-09-22 2014-08-19 Olympus Corporation Space ensuring device
WO2011043126A1 (fr) 2009-10-06 2011-04-14 オリンパス株式会社 Dispositif de guidage
CN104602627A (zh) * 2012-11-13 2015-05-06 奥林巴斯株式会社 医疗器件

Also Published As

Publication number Publication date
AU5370498A (en) 1998-06-29
CA2273948A1 (fr) 1998-06-11
AU744703B2 (en) 2002-02-28
EP0952788A1 (fr) 1999-11-03
US5931810A (en) 1999-08-03
JP2001505464A (ja) 2001-04-24
US6156009A (en) 2000-12-05

Similar Documents

Publication Publication Date Title
AU744703B2 (en) Apparatus and method for accessing the pericardial space
US6592552B1 (en) Direct pericardial access device and method
US5972013A (en) Direct pericardial access device with deflecting mechanism and method
US6231518B1 (en) Intrapericardial electrophysiological procedures
US6139522A (en) Electrophysiology positioning catheter
EP1171191B1 (fr) Kit pour l'acces transveineux a l'espace pericardique par l'oreillette droite
AU745717B2 (en) Treatment method via the pericardial space
WO1999062405A9 (fr) Dispositif de localisation et d'ecartement pour ouverture de tissus et methode d'utilisation
EP0981384A4 (fr) Procede d'acces transveineux a l'espace pericardique via l'oreillette droite
US6723069B1 (en) Electrophysiology positioning catheter
AU762622B2 (en) Intrapericardial procedures and apparatuses
JP2024502267A (ja) 中隔パンチ並びに治療器具の送達及び操縦のための装置及び方法
WO1995009662A1 (fr) Instrument de sondage
Maisch et al. Alternative Techniques for Pericardiocentesis

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AL AM AT AT AU AZ BA BB BG BR BY CA CH CN CU CZ CZ DE DE DK DK EE EE ES FI FI GB GE GH HU ID IL IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MD MG MK MN MW MX NO NZ PL PT RO RU SD SE SG SI SK SK SL TJ TM TR TT UA UG UZ VN YU ZW AM AZ BY KG KZ MD RU TJ TM

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): GH KE LS MW SD SZ UG ZW AT BE CH DE DK ES FI FR

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
121 Ep: the epo has been informed by wipo that ep was designated in this application
ENP Entry into the national phase

Ref document number: 2273948

Country of ref document: CA

WWE Wipo information: entry into national phase

Ref document number: 53704/98

Country of ref document: AU

ENP Entry into the national phase

Ref country code: JP

Ref document number: 1998 525767

Kind code of ref document: A

Format of ref document f/p: F

WWE Wipo information: entry into national phase

Ref document number: 1997950804

Country of ref document: EP

REG Reference to national code

Ref country code: DE

Ref legal event code: 8642

WWP Wipo information: published in national office

Ref document number: 1997950804

Country of ref document: EP

WWW Wipo information: withdrawn in national office

Ref document number: 1997950804

Country of ref document: EP

WWG Wipo information: grant in national office

Ref document number: 53704/98

Country of ref document: AU